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Clinical and cardiac magnetic resonance findings in post-COVID patients referred for suspected myocarditis.

Publication ,  Journal Article
Breitbart, P; Koch, A; Schmidt, M; Magedanz, A; Lindhoff-Last, E; Voigtländer, T; Schmermund, A; Mehta, RH; Eggebrecht, H
Published in: Clin Res Cardiol
November 2021

OBJECTIVES: We assessed possible myocardial involvement in previously cardiac healthy post-COVID patients referred for persisting symptoms with suspected myocarditis. BACKGROUND: Prior studies suggested myocardial inflammation in patients with coronavirus-induced disease 2019 (COVID-19). However, the prevalence of cardiac involvement among COVID patients varied between 1.4 and 78%. METHODS: A total of 56 post-COVID patients without previous heart diseases were included consecutively into this study. All patients had positive antibody titers against SARS-CoV-2. Patients were referred for persistent symptoms such as chest pain/discomfort, shortness of breath, or intolerance to activity. All patients underwent standardized cardiac assessment including electrocardiogram (ECG), cardiac biomarkers, echocardiography, and cardiac magnetic resonance (CMR). RESULTS: 56 Patients (46 ± 12 years, 54% females) presented 71 ± 66 days after their COVID-19 disease. In most patients, the course of COVID-19 was mild, with hospital treatment being necessary in five (9%). At presentation, patients most often reported persistent fatigue (75%), chest pain (71%), and shortness of breath (66%). Acute myocarditis was confirmed by T1/T2-weighed CMR and elevated NTpro-BNP levels in a single patient (2%). Left ventricular ejection fraction was 56% in this patient. Additional eight patients (14%) showed suspicious CMR findings, including myocardial edema without fibrosis (n = 3), or non-ischemic myocardial injury suggesting previous inflammation (n = 5). However, myocarditis could ultimately not be confirmed according to 2018 Lake Louise criteria; ECG, echo and lab findings were inconspicuous in all eight patients. CONCLUSIONS: Among 56 post-COVID patients with persistent thoracic complaints final diagnosis of myocarditis could be confirmed in a single patient using CMR.

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Published In

Clin Res Cardiol

DOI

EISSN

1861-0692

Publication Date

November 2021

Volume

110

Issue

11

Start / End Page

1832 / 1840

Location

Germany

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Myocarditis
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Heart
  • Female
  • Electrocardiography
 

Citation

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Breitbart, P., Koch, A., Schmidt, M., Magedanz, A., Lindhoff-Last, E., Voigtländer, T., … Eggebrecht, H. (2021). Clinical and cardiac magnetic resonance findings in post-COVID patients referred for suspected myocarditis. Clin Res Cardiol, 110(11), 1832–1840. https://doi.org/10.1007/s00392-021-01929-5
Breitbart, Philipp, Alexander Koch, Marco Schmidt, Annett Magedanz, Edelgard Lindhoff-Last, Thomas Voigtländer, Axel Schmermund, Rajendra H. Mehta, and Holger Eggebrecht. “Clinical and cardiac magnetic resonance findings in post-COVID patients referred for suspected myocarditis.Clin Res Cardiol 110, no. 11 (November 2021): 1832–40. https://doi.org/10.1007/s00392-021-01929-5.
Breitbart P, Koch A, Schmidt M, Magedanz A, Lindhoff-Last E, Voigtländer T, et al. Clinical and cardiac magnetic resonance findings in post-COVID patients referred for suspected myocarditis. Clin Res Cardiol. 2021 Nov;110(11):1832–40.
Breitbart, Philipp, et al. “Clinical and cardiac magnetic resonance findings in post-COVID patients referred for suspected myocarditis.Clin Res Cardiol, vol. 110, no. 11, Nov. 2021, pp. 1832–40. Pubmed, doi:10.1007/s00392-021-01929-5.
Breitbart P, Koch A, Schmidt M, Magedanz A, Lindhoff-Last E, Voigtländer T, Schmermund A, Mehta RH, Eggebrecht H. Clinical and cardiac magnetic resonance findings in post-COVID patients referred for suspected myocarditis. Clin Res Cardiol. 2021 Nov;110(11):1832–1840.
Journal cover image

Published In

Clin Res Cardiol

DOI

EISSN

1861-0692

Publication Date

November 2021

Volume

110

Issue

11

Start / End Page

1832 / 1840

Location

Germany

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Myocarditis
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Heart
  • Female
  • Electrocardiography